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United States Specialists Refine the HIPEC Approach

June 25, 2018

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Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an alternative to traditional systemic chemotherapy, and one of the most innovative treatments available for complex abdominal cancers. While traditional chemotherapy is delivered through the bloodstream of a patient, HIPEC is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen of a patient during surgery.

Benefits of Hyperthermic Intraperitoneal Chemotherapy

Traditional chemotherapy causes severe side effects, and can only be safely administered in limited dosages. HIPEC, on the other hand, when delivered directly to the abdomen, allows doctors to increase the dosage while simultaneously decreasing side effects. During the procedure, doctors remove the tumors and then immediately fill the abdominal cavity of the patient with a heated chemotherapy mixture.

HIPEC should be repeated several times. Consequently, American doctors are developing procedures for repeating liquid intraperitoneal chemotherapy.

While peritoneal mesothelioma specialists are focusing on refining the HIPEC approach, European doctors are performing another alternative, innovative treatment for cancers called Pressurized Intraperitoneal Aerosol Chemotherapy, or PIPAC.

Pressurized Intraperitoneal Aerosol Chemotherapy also has Benefits

PIPAC is similar to HIPEC. Like HIPEC, PIPAC is delivered directly to the abdomen. However, instead of liquid, doctors use aerosol. Administered before or after surgery, doctors pump aerosol chemotherapy into the abdomen of the patient, which inflates it, much like a balloon. The intent is to spread the chemotherapy spray throughout the abdomen with the pressure from the chemotherapy spray, to eliminate all traces of cancer.

Researchers believe this procedure helps infiltrate the tumor, because the chemotherapy is more concentrated. The downside, however, is that it increases the risk of complications post-abdominal surgery. Higher concentrations mean a greater chance of debilitated healthy tissues, like the small intestine. Nonetheless, European researchers believe PIPAC is a more effective approach than HIPEC.

BMC Cancer Study Suggests PIPAC is more Effective than HIPEC

A recent study published in the April edition of BMC Cancer reported that PIPAC not only shrunk tumors, but also relieved symptoms in more than half of the patients in the study.

Other highlights of the study included:

• Significant reduction of tumors for 15 of the 24 peritoneal mesothelioma patients after repeated treatments.
• Median survival time of 26.6 months.
• Reduced cancer symptoms such as appetite loss, nausea, and fatigue.
• Significant improvement in the quality of life reported by many patients.
• Low mortality rate of 4% (one patient died due to kidney failure after the second treatment).

While other parts of the world are moving forward with PIPAC, this method is not yet available in the United States. Instead, American doctors continue to refine HIPEC techniques.

European doctors have used the PIPAC method on many types of cancer since 2013. Europe, Asia, Australia, and South America continue with ongoing PIPAC clinic trials.

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